Program Operations Manual System (POMS)

GN 04060.020 Actions Necessary to Permit Reopening Within the One-Year or Four-Year Period

To reopen a determination or decision under either the 1-year or 4-year rule (see GN 04060.005), it is necessary that (A) a written request be filed by a party to the determination or decision, or by an authorized representative, within the applicable time limit; or (B) the Health Care Financing Administration, an intermediary, or carrier or a hearing officer, Administrative Law Judge or member of the Appeals Council takes some action (which can be documented) within the applicable time limit questioning the correctness of the determination or decision.